Carly Jacqueline Griffin, FNP in Portland, OR

Carly Jacqueline Griffin, FNP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Oregon. Her current practice location is 1111 Ne 99th Ave Ste 200, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 963-3030.

Carly Jacqueline Griffin is licensed to practice in Oregon (license number 201705874NP-PP) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558748293.

Contact Information

	Carly Jacqueline Griffin, FNP
	1111 Ne 99th Ave Ste 200, Portland, OR 97220-9442
	(503) 963-3030
	(503) 963-3140

Map and Direction

Provider's Profile

Full Name	Carly Jacqueline Griffin
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1111 Ne 99th Ave Ste 200, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558748293
Provider Enumeration Date: 05/01/2015
Last Update Date: 11/16/2021

Medicare PECOS Information:

PECOS PAC ID: 7517230469
Enrollment ID: I20170829002060

Medical Identifiers

Medical identifiers for Carly Jacqueline Griffin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558748293	NPI	-	NPPES
2084641	Medicaid	WA
500730448	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	201705874NP-PP (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carly Jacqueline Griffin allows following entities to bill medicare on her behalf.

Entity Name	The Oregon Clinic, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265417174 PECOS PAC ID: 2860390408 Enrollment ID: O20031222000096

Entity Name	Northwest Acute Care Specialists Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215983200 PECOS PAC ID: 7012807373 Enrollment ID: O20040318001535

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carly Jacqueline Griffin is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Carly Jacqueline Griffin, FNP 847 Ne 19th Ave Ste 300, Portland, OR 97232-2686 Ph: (503) 963-2801	Carly Jacqueline Griffin, FNP 1111 Ne 99th Ave Ste 200, Portland, OR 97220-9442 Ph: (503) 963-3030

Reviews and Comments

Nurse Practitioner Nurses in Portland, OR

Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555
Iva Juric, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St Ste 730, Portland, OR 97205 Phone: 971-354-9242
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700

Carly Jacqueline Griffin, FNP - Medicare Nurse Practitioner in Portland, OR